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Inspection Summary


Overall summary & rating

Updated 15 July 2016

We carried out an announced comprehensive inspection on 16 June 2016 to ask the practice the following key questions; Are services safe, effective, caring, responsive and well-led?

Our findings were:

Are services safe?

We found that this practice was providing safe care in accordance with the relevant regulations.

Are services effective?

We found that this practice was providing effective care in accordance with the relevant regulations.

Are services caring?

We found that this practice was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found that this practice was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found that this practice was providing well-led care in accordance with the relevant regulations.

Background

Deu Dental Headingley is situated in the Headingly area of Leeds, West Yorkshire. It offers mainly NHS treatment to patients of all ages but also offers private dental treatments. The services include preventative advice and treatment and routine restorative dental care.

The practice has three surgeries, a decontamination room, an X-ray room, two waiting areas and a reception area. The reception area, one waiting area, the X-ray room and one surgery are on the ground floor. The other two surgeries and the second smaller waiting area are on the first floor. There are accessible toilet facilities on the ground floor of the premises.

There are three dentists (one of which is a foundation dentist), two dental hygienists, six dental nurses (three of which are trainees), two receptionists and a practice manager. 

The opening hours are Monday to Friday from 9-00am to 5-30pm.

The practice owner is registered with the Care Quality Commission (CQC) as an individual. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the practice is run.

During the inspection we spoke with three patients who used the service and reviewed 74 completed CQC comment cards. The patients were all positive about the care and treatment they received at the practice. Comments included that the premises were hygienic and safe, they were made to feel relaxed and comfortable and that staff were polite, friendly and helpful. Patients also commented that treatment was well explained and they were given good advice with respect to dental hygiene.

Our key findings were:

  • The practice had systems in place to assess and manage risks to patients and staff including infection prevention, control and health and safety and the management of medical emergencies.
  • Staff were qualified and had received training appropriate to their roles.
  • Dental care records were detailed and showed that treatment was planned in line with current best practice guidelines.
  • Oral health advice and treatment were provided in-line with the ‘Delivering Better Oral Health’ toolkit (DBOH).
  • We observed that patients were treated with kindness and respect by staff. Staff ensured there was sufficient time to explain fully the care and treatment they were providing in a way patients understood.
  • Patients were involved in making decisions about their treatment and were given clear explanations about their proposed treatment including costs, benefits and risks.
  • Patients were able to make routine and emergency appointments when needed.
  • Staff from the practice participated in smile month and made visits to local schools to provide oral hygiene advice
  • The practice had an effective complaints system in place and there was an openness and transparency in how these were dealt with.
  • The practice had effective governance arrangements in place and regularly audited clinical and non-clinical areas relating to the dental practice

There were areas where the provider could make improvements and should:

  • Review the practice’s arrangements the storage of local anaesthetics.
Inspection areas

Safe

No action required

Updated 15 July 2016

We found that this practice was providing safe care in accordance with the relevant regulations.

The practice had a policy and process in place for reporting of significant events. Staff told us they felt confident about reporting incidents, accidents and Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013 (RIDDOR).

Staff had received training in safeguarding at the appropriate level and knew the signs of abuse and who to report them to.

Staff were suitably qualified for their roles and the practice had undertaken the relevant recruitment checks to ensure patient safety.

Patients’ medical histories were obtained before any treatment took place. The dentists were aware of any health or medication issues which could affect the planning of treatment. Staff were trained to deal with medical emergencies. All emergency equipment and medicines were in date and in accordance with the British National Formulary (BNF) and Resuscitation Council UK guidelines.

The decontamination procedures were effective and the equipment involved in the decontamination process was regularly serviced, validated and checked to ensure it was safe to use.

Effective

No action required

Updated 15 July 2016

We found that this practice was providing effective care in accordance with the relevant regulations.

Patients’ dental care records provided comprehensive information about their current dental needs and past treatment. The practice monitored any changes to the patient’s oral health and provided treatment when appropriate.

The dentists followed best practice guidelines when delivering dental care. These included Faculty of General Dental Practice (FGDP), National Institute for Health and Care Excellence (NICE) and guidance from the British Society of Periodontology (BSP). The dentists were aware of the importance of prevention and followed the guidance from the ‘Delivering Better Oral Health’ toolkit (DBOH) with regards to fluoride application and oral hygiene advice.

Staff were encouraged to complete training relevant to their roles and this was monitored by the practice manager. The clinical staff were up to date with their continuing professional development (CPD).

Referrals were made to secondary care services if the treatment required was not provided by the practice.

Caring

No action required

Updated 15 July 2016

We found that this practice was providing caring services in accordance with the relevant regulations.

During the inspection we spoke with three patients who used the service and reviewed 74 completed CQC comment cards. Patients commented that they were made to feel comfortable and that staff were polite, friendly and helpful. Patients also commented that treatment was well explained and they felt involved in decisions about treatment.

We observed the staff to be welcoming and caring towards the patients.

We observed privacy and confidentiality were maintained for patients using the service on the day of the inspection.

Staff explained that enough time was allocated in order to ensure that the treatment and care was fully explained to patients in a way which they understood.

Responsive

No action required

Updated 15 July 2016

We found that this practice was providing responsive care in accordance with the relevant regulations.

The practice had an efficient appointment system in place to respond to patients’ needs. There were vacant appointments slots for urgent or emergency appointments each day. The reception staff used a triage system for patients requesting an emergency appointment. There were clear instructions for patients requiring urgent care when the practice was closed.

There was a procedure in place for responding to patients’ complaints. This involved acknowledging, investigating and responding to individual complaints or concerns. Staff were familiar with the complaints procedure.

The practice had made reasonable adjustments to enable patients in a wheelchair or with limited mobility to access treatment.

Well-led

No action required

Updated 15 July 2016

We found that this practice was providing well-led care in accordance with the relevant regulations.

There was a clearly defined management structure in place and all staff felt supported and appreciated in their own particular roles. The practice manager was responsible for the day to day running of the practice.

Effective arrangements were in place to share information with staff by means of monthly practice meetings which were well minuted for those staff unable to attend.

The practice regularly audited clinical and non-clinical areas as part of a system of continuous improvement and learning.

The practice was proactive with regards to seeking feedback from patients. They conducted patient satisfaction surveys, were currently undertaking the NHS Friends and Family Test (FFT) and there was a comments box in the waiting room for patients to make suggestions to the practice.